For Pharmacists

Pharmacist Opioid Abuse Management Guidelines- When to contact the prescriber

According to the United States Drug Enforcement Agency (DEA), pharmacists “have a personal responsibility to protect their practice from becoming an easy target for drug diversion.”

There are several points in time upon the receipt of a concerning opioid prescription that a pharmacist may want to reach out to the prescriber to discuss concerns about the prescription.

• If a pharmacist suspects a prescription may have been forged, he/she should contact the prescriber to confirm the legitimacy of the prescription
• If there is concern based on profile and/or information from the Prescription Monitoring Program that the patient may be abusing opioid medications
• If the pharmacist elicits patient concern about abuse and/or a caregiver shares concern about potential patient abuse
• If the pharmacist has concerns regarding the quantity or strengths of opioid doses, safety concerns regarding drug interactions between opioids and other medications, and other opioid interactions between the patient’s health conditions, diet, and other substance use (alcohol, and illicit drugs).

The call to the prescriber should occur regardless of whether the patient fills the prescription at the pharmacy or not. Patients who leave the pharmacy without getting the prescription or take the prescription with them may be of greatest concern for abuse.

It is reasonable for a pharmacist to call the prescriber based on any combination of the following:

• opioid prescriptions filled at multiple pharmacies
• opioid prescriptions written by multiple prescribers
•  the prescribing of multiple opioids and in combination with benzodiazepines